title: Relationship between microcirculatory dysfunction and resolution of ST-segment elevation in the early phase after primary angioplasty in patients with ST-segment elevation myocardial infarction.
abstract: OBJECTIVE
  The aim of this study was to evaluate relationships between the degree of resolution of the ST-segment elevation (ST segment resolution; STR) and the extent of microcirculatory dysfunction in infarct-related area (IRA) in patients with ST-segment elevation myocardial infarction (STEMI) using (13)N-ammonia positron emission tomography (N-PET).
  
  
  METHODS
  The subjects comprised 33 patients with STEMI who underwent successful reperfusion. Serial 12-lead electrocardiography (ECG) was performed at the baseline and at 100 min after reperfusion to calculate STR. The myocardial flow reserve (MFR) was assessed quantitatively using N-PET at 2 weeks after the onset. The summed defect score (SDS) of (99m)Tc-tetrofosmin myocardial perfusion imaging was used as an index of the severity of myocardial infarction. To assess the extent of post-infarct left ventricular remodeling, the changes in the LVEDVI (ΔEDVI) were also calculated.
  
  
  RESULTS
  A significant correlation of the STR to the MFR in IRA (r = 0.68, p < 0.0001) was observed. A significant correlation was also identified between the SDS and the baseline sum ST-segment elevation (r = 0.65, p < 0.0001), while no correlation was observed between the SDS and the STR. Furthermore, a significant inverse correlation of the STR with the ΔEDVI was also recognized (r = -0.58, p < 0.01).
  
  
  CONCLUSIONS
  These data indicate that STR after successful reperfusion in STEMI is closely related to the extent of microcirculatory disturbance; in other words, incomplete STR may be a marker of persistent microcirculatory dysfunction after reperfusion therapy.
authors.affiliation: First Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Amaya
authors.forename: Akira
authors.initials: A
authors.lastname: Nakano
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Uzui
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Mitsuke
authors.forename: Toru
authors.initials: T
authors.lastname: Geshi
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Okazawa
authors.forename: Takanori
authors.initials: T
authors.lastname: Ueda
authors.forename: Jong-Dae
authors.initials: JD
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome